42例药源性血小板减少症的帕累托分析

目的:了解中国科学技术大学附属第一医院(以下简称"我院")药源性血小板减少症(drug-induced thrombocytopenia,DITP)的特点,为防范临床用药风险和提高用药合理性提供参考。方法:收集2018年1月至2020年7月我院上报的42例DITP住院患者的病历资料,利用帕累托法对上报人员职业、患者年龄与性别、药品种类、给药方式、临床表现及处理措施等进行统计分析。结果:42例DITP中,以药师上报为主(38例);男性患者、女性患者各21例;患者年龄主要集中于>18~<80岁,为主要因素;涉及9类药物23种药品,其中抗肿瘤药引起DITP病例数最多(15例),抗肿瘤药、抗菌药物、抗癫痫药和抗血小板药为主要因素;涉及5种给药方式,其中静脉滴注为主要因素;DITP多发生于用药后1~14 d(26例),为主要因素;12例DITP仅停药未对症处理,30例DITP给予对症治疗,主要为重组人白介素-11与输注血小板联合治疗。结论:临床使用可能引起DITP的药物时,应加强安全用药意识,密切监测血小板计数,尽早发现DITP并对症治疗,以确保临床用药安全。

Pareto Analysis on 42 Cases of Drug-Induced Thrombocytopenia

OBJECTIVE:To probe into the characteristics drug-induced thrombocytopenia(DITP)in the First Affiliated Hospital of University of Science and Technology of China(hereinafter referred to as"our hospital"),so as to provide reference for preventing clinical medication risk and improving rational medication.METHODS:Data of the42 cases of DITP patients reported by our hospital from Jan.2018 to Jul.2020 were collected and analyzed by Pareto method in terms of occupation,age and gender,categories of drug,administration route,clinical manifestations and treatment measures.RESULTS:Among the 42 cases of DITP,mainly reported by pharmacists(38 cases);there were21 male and 21 female patients;mainly aged>18-<80 years old;9 categories including 23 kinds of drugs were involved,of which antineoplastics had caused the most DITP cases(15 cases),antineoplastics,antibiotics,antiepileptics and antiplatelet drugs were the main factors;5 ways of administration were involved,of which intravenous drip was the main factor;the DITP was mostly occurred during 1-14 days after medication(26 cases);12 cases if DIPT were treated with drug withdrawal without symptomatic treatment,30 cases were given symptomatic treatment,mainly given recombinant human interleukin-11(rhIL-11)combined with platelet transfusion for treatment.CONCLUSIONS:When clinical application of drugs that may cause DITP,awareness of safe medication should be strengthened,platelet counts should be closely monitored,DITP should be detected as soon as possible and given symptomatic treatment to ensure clinical medication safety.